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Spinal Tumors 脊柱肿瘤 A Patient’s Guide to Spinal Tumors脊柱肿瘤患者指南 Symptoms症状 What does a spinal tumor feel like? 得了脊柱肿瘤会有什么感觉？ Sometimes the tumors are found before they cause any symptoms. The symptoms will vary depending on where the tumor is located and what tissues are involved. 有时在肿瘤引起症状之前就被发现了。根据肿瘤生长的位置及波及的组织，症状各不相同。 At times, pain, bowel or bladder problems, sexual dysfunction, change in sensation, or muscle weakness of the arms or legs may alert you to the problem. This often means that the tumor is compressing the spinal cord or nerve root. Tumors that originate in the spinal cord itself may not cause pain. Pain that awakens you in the night or development of scoliosis (abnormal spine curve) may be a sign that the bone of the vertebra is being destroyed by a spinal tumor. 有时，疼痛、大小便困难、性功能障碍、感觉异常、上肢或下肢肌肉无力，会警示你得了病。这往往提示肿瘤压迫了脊髓或神经根。源于脊髓本身的肿瘤可能不引起疼痛。夜间令你痛醒或发生脊柱侧弯（异常的脊柱弯曲）是椎骨被脊柱肿瘤破坏的信号。 Symptoms may have a gradual or rapid onset. Symptoms usually worsen without treatment. 症状可能缓慢或快速进展。如果不进行治疗，症状通常会加重。 Diagnosis诊断 How will my doctor diagnose the problem? 医生如何来诊断这种疾病？ Diagnosis begins with a thorough history and physical exam. Your doctor will ask questions about your symptoms and how your problem is affecting your daily activities. This will include questions about pain, feelings of numbness or weakness, change in bowel or bladder function, and whether you have noticed any changes in the way you walk. Your doctor will want to know if have been diagnosed with any type of cancer in the past. 诊断始于详细的病史和体格检查。你的医生会询问有关你的症状的问题，还有你的疾病对你日常活动影响程度多大。这些问题包括：疼痛、麻木感、无力、大小便功能改变、还有你是否发现行走方式的改变。你的医生还想了解你以前是否被诊断出任何种类的肿瘤。 During the physical exam, sensation of the skin, muscle strength, and reflexes are tested. Your doctor may ask you to walk to see if there are any changes in your walking pattern. 当进行体格检查时，会检查皮肤感觉、肌肉力量和反射。你的医生可能会让你行走以观察你行走模式有无改变。 In addition to having lab work done, there are several procedures that can help your doctor diagnose a spinal tumor. 除了进行实验室检查，还有一些检查可以帮助你的医生诊断脊柱肿瘤。 Magnetic resonance imaging (MRI) allows your doctor to look at slices of the area in question. The MRI machine uses magnetic waves, not X-rays to show the soft tissues of the body. This includes the spinal cord and nerves. The test may require the use of dye that is given intravenously. 核磁共振（MRI）可让你的医生分层查看有疑问的节段。MRI机器使用磁力波，而非X线，可显示人体的软组织，包括脊髓和神经，有时需要静脉注入造影剂（增强磁共振）。 Computed tomography (CT) scan may be ordered when an MRI is unavailable. Dye will be introduced into the spinal canal fluid so that the spinal cord and nerve root anatomy are identified better. When dye is injected for this purpose, the technique is called a myelogram. 如果不便使用MRI，可选择计算机辅助断层扫描（CT）。在椎管脑脊液中注入造影剂，可以更好地显示脊髓和神经根的解剖。为了这种目的注入造影剂，这项技术称作脊髓造影。 X-rays of the spine may be ordered when there is the likelihood of metastasized tumor from cancer elsewhere. It can show only changes in the bones. Many primary spinal tumors do not affect the bone when they are in the early stage. 如果怀疑是来自于别处癌肿的转移瘤，可能会照脊柱的X线片。它只能显示骨骼的变化。很多原发脊柱肿瘤在早期不影响骨头。 Bone scans can be used to detect fracture, bone infection, or cancer. A radioactive tracer, technetium (Tc), is injected into your vein. Where there is an increase in metabolic activity, such as is the case with cancer, the Tc will be more concentrated. Spinal tumors may be malignant, or metastasized from cancer somewhere else in the body. It is helpful to use a scan to see if there are other areas in the body where the cancer may be. 骨扫描用于发现骨折、骨感染或癌。通过静脉注入放射性示踪剂--锝（Tc），哪里代谢活性增加，比如患癌的病例，锝较多地浓聚。脊柱肿瘤可能是恶性的，或从身体其它部位的癌肿转移而来，骨扫描有助于发现身体其他部位是否存在癌性病灶。 A biopsy helps determine the type of the tumor. A biopsy may require surgery. Sometimes it can be performed using a needle while using CT for guidance. A piece of the tumor is removed and looked at under a microscope. 活检有助于明确肿瘤的分类，这可能需要手术，有时活检可在CT引导下用针穿刺获得，切下的小片肿瘤组织在显微镜下观察。 Types of Spinal Tumors脊柱肿瘤的类型 Malignant Spinal Tumors 恶性脊柱肿瘤 Osteosarcoma occurs most often in children, adolescents, and young adults. Males are more likely to be affected than females. Treatment usually consists of removal of the tumor when possible as well as chemotherapy. Radiation therapy is not effective. Older persons with Paget’s disease or who have had radiation therapy may develop this type of tumor. 骨肉瘤好发于儿童、青少年或年轻人，男性比女性发病率高。治疗通常包括尽可能切除肿瘤同时进行化疗，放疗不敏感。患有变形性骨炎（Paget’s病）或做过放疗的老年人也可能发生这类肿瘤。 Ewing’s Sarcoma occurs in the bone of the spine or surrounding tissues. It usually affects adolescents and those in early adulthood. When it involves the spine, it may cause paralysis and loss of bladder or bowel function (incontinence), numbness or tingling. Removing the tumor is preferred if possible, in combination with chemotherapy and sometimes radiation. If the tumor has traveled to the bone marrow, stem cell transplant is a more aggressive form of treatment. 尤文氏肉瘤可发生于脊椎骨或周围组织，好发于青少年和青年。当影响脊柱时，可引起麻痹、大小便功能障碍（失禁）、麻木、刺痛等。如有可能，最好切除肿瘤，并联合化疗，有时需要放疗。如肿瘤转移到骨髓，干细胞移植是积极治疗的手段。 Chondrosarcoma usually occurs in adults and is most common in flat bones such as the pelvis. They usually are noticed because they cause pain and swelling. Surgery is performed to remove the tumor and any tumors that have spread, usually to the lung. In most cases, chemotherapy is not effective. 软骨肉瘤常发生于成人，多发生于扁平骨，比如骨盆。它们常常因为引起疼痛和肿胀而被发现。肿瘤和转移灶可手术切除。肺部转移常见。在大部分病例，化疗无效。 Astrocytomas are tumors that involve nerve cells within the spinal cord and brain. They most commonly occur in children and adolescents. Neurological symptoms such as weakness and/or sensory changes may be the cause for seeking treatment. They tend to spread throughout the spinal cord and brain. Astrocytomas in the spine can usually be removed surgically. However, they are difficult to completely remove. Radiation therapy may be necessary following surgery to slow the spread of the tumor. 星形细胞瘤是侵犯脊髓和大脑神经细胞的肿瘤。常见于儿童和青少年。患者因无力和/或感觉变化等症状而就诊。星形细胞瘤易于在脊髓和大脑中扩散，发生于脊髓的可手术切除，然而，要彻底切除很困难。术后可能需要进行放疗以减慢肿瘤的扩散。 Cancer in the bone marrow is called multiple myeloma. Bone tissue is destroyed by excessive growth of plasma cells in the bone marrow. When X-rayed it appears that holes have been taken out of the bone. These are called osteolytic lesions. Plasma cells are part of the immune system and in multiple myeloma they grow uncontrolled forming tumors in the bone marrow. Any part of the skeletal system (bones) can be affected including the spine. For multiple myeloma, treatment may include chemotherapy and other medications, radiation, and stem cell transplantation. 多发性骨髓瘤长于骨髓内。骨组织被在骨髓中过度生长的浆细胞破坏。在X线上显示骨组织内出现孔洞，被称为溶骨性病变。浆细胞是免疫系统的一部分，在多发性骨髓瘤，浆细胞生长失控，在骨髓内形成肿瘤。包括脊柱在内的任何骨骼均可受累。对于多发性骨髓瘤，治疗包括化疗和其它药物治疗、放疗和干细胞移植。 Benign Spinal Tumors 良性脊柱肿瘤 Osteoid osteoma is the most common of the benign tumors involving the bone of the spine. It is usually found during adolescence. It may be discovered because of scoliosis or curvature of the spine. It may cause pain that does not ease up, and is worse at night. Anti-inflammatory medications are used for treatment. Sometimes removal of the tumor by surgery is necessary. A newer, less invasive treatment is called radio-frequency ablation. These tumors rarely recur (come back). 骨样骨瘤是影响脊柱的最常见的良性肿瘤。青少年好发。常因脊柱侧弯或曲度改变而被发现。可引起难以缓解的疼痛，夜间更为明显。治疗可使用抗炎镇痛药。有时需要手术切除肿瘤。更新更微创的治疗方法是射频消融，这类肿瘤很少复发。 Related Document: A Patient’s Guide to Radiofrequency Ablation 相关文章：射频消融患者指南（翻译招募中，有意者请留言） Osteoblastomas are larger versions of osteoid osteomas. They tend to be found in people under the age of 30. They may cause scoliosis or curvature of the spine. Osteoblastomas tend to be more aggressive and require surgery to remove the tumor. There is a 10% chance that the tumor may recur. 骨母细胞瘤较骨样骨瘤大，好发于30岁以下，可引起脊柱侧弯或后凸。骨母细胞瘤更倾向于侵袭性，需要手术切除肿瘤。肿瘤复发的机率有10%。 Giant cell tumors are very rare and tend to affect the vertebral body of a spinal segment. They can be aggressive and sometimes spread to other parts of the body, usually the lung. Treatment involves surgery to remove the tumor. Also, radiation therapy may be used. 巨细胞瘤非常少见，常影响一个脊柱节段的椎体，可有侵袭性，有时会扩散到身体其它部位，常见于肺。治疗包括手术切除肿瘤，也可作放疗。 Enchondromas are tumors involving cartilage. They may grow into the spinal canal or press on the spinal nerve roots. When they cause paralysis, bowel or bladder incontinence, or other neurological symptoms they are surgically removed. They rarely can become chondrosarcomas, which are malignant tumors that can spread to other parts of the body. 内生软骨瘤影响软骨，可长入椎管或压迫脊神经根。当引起麻痹、大小便失禁或其他神经症状时，可行手术切除。很少部分可转变为软骨肉瘤，后者是恶性肿瘤，可转移到身体其它部位。 Hemangiomas are tumors involving blood vessels that affect the vertebral body of a spinal segment. They are most commonly found in the thoracic or lumbar portion of the spine. They occur more frequently during mid-life. They are found more often in women than men. They can be a source of pain but often do not cause pain. They may be large enough to cause collapse of the vertebral body which could affect the spinal cord or nerve roots. 血管瘤源于血管，影响一个脊柱节段的椎体，好发于胸椎和腰椎。中年人多见，女性多于男性。血管瘤可能是疼痛的原因，但通常不引起疼痛。当肿瘤太大时，会引起椎体塌陷，可能影响脊髓或神经根。 Meningioma is the most common spinal cord tumor. They tend to occur in older adults and are more common in women. They are usually treated with surgical removal. Rarely, meningiomas recur or spread to other parts of the body. 脑膜瘤是常见的脊髓肿瘤，好发于老年人，女性多见，常需手术切除。脑膜瘤复发或转移到身体其它部位罕见。 Ependymoma is a tumor involving the cells lining the canal in the center of the spinal cord. These tumors have the greatest chance for surgical cure. 室管膜瘤侵犯脊髓中央管细胞。手术治愈的希望较高。 Schwannoma is a tumor that involves the covering or sheath of peripheral nerve fibers. It may cause weakness, paralysis or sensory changes such as numbness. It can be removed surgically. 神经鞘瘤侵犯外周神经纤维的被膜（鞘），可引起无力、麻痹或感觉异常比如麻木。神经鞘瘤可手术切除。 Chordomas are tumors that are typically found at the lower end of the spine. Because they can aggressively grow, they can cause compression of the spinal cord or nerve roots causing neurological problems. Treatment involves surgery to remove the tumor. Unfortunately they come back, but do not spread to other areas of the body. 脊索瘤通常发现于脊柱的下端。由于它们呈侵袭性生长，它们可压迫脊髓和神经根，引起神经症状。治疗主要是手术切除。如不幸复发，但不会转移到身体其它部位。 Plasmacytoma is a single tumor involving the bone of a spinal segment. It can have characteristic punched out holes in the bone on X-ray. It can cause a compression fracture of the vertebral body. This can cause neurological symptoms. Spinal surgery to decrease pain and improve function may be necessary. Plasmacytoma is felt to be an isolated form of multiple myeloma, which will then develop lesions in other bones in the body. Multiple myeloma is a malignant process and is the most common primary bone cancer. 浆细胞瘤是影响一个脊柱节段骨组织的单发肿瘤。在X线上特征性的表现是骨头上打了洞。浆细胞瘤可以引起椎体压缩性骨折，这时可能引起神经症状。脊柱手术可减轻疼痛，改善功能，是必要的。浆细胞瘤可能是多发性骨髓瘤的孤立形式。多发性骨髓瘤可在人体其它骨组织引起病损，呈恶性生长，是常见的原发性骨肿瘤。 （胡佰文 译） 患者指南，图文并茂， 分门别类，构思巧妙。 深入浅出，中英对照， 医患携手，共同探讨。 能力有限，英语欠好， 时间仓促，错误不少。 恳请各位，留言指导， 以利再版，更加周到。 |
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